Angela Wagner

NPI #1437565025 in Herrin, Illinois

Provider Information

NPI Number: 1437565025
Entity Type: Individual
Name: Angela Wagner
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Enumeration Date: Jul 3, 2014
Last Updated: Jul 3, 2014

Practice Location

Address: 3313 PATRIOT CT
City: Herrin
State: Illinois
ZIP Code: 62948-3782
Phone: (618) 993-9910

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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